How To Choose Your Nursing Specialism

"In the end, your course and route to qualifying will run a lot smoother if you are committed and doing something you really enjoy."

Learning Disability Nurse, Lauren Young, gives her insights into what should be considered when picking your Nursing specialism, and why researching the roles is so important.

Topics covered in this article

Introduction

What Is Your Passion?

Your Dream As A Reality

Think About The Skills You Already Possess

Consider Your Experience

Making The Right Choice

Introduction

There are four main Nurse specialisms in the UK.

These are Adult Nursing, Children’s Nursing, Mental Health Nursing, and Learning Disability Nursing.

UK universities focus on these areas from the outset, therefore your decision will also influence which universities and courses you could apply for.

It is also possible to study for a dual degree – for example, in adult and child nursing, or mental health and learning disabilities.

You might prefer to qualify as a dual practitioner, for example in both learning disability nursing and social work.

You will need to think carefully if these routes appeal to you more, or if you would like to specialise.

Several factors could influence your choice as to which specialism you feel you would most like to work in.

This article will go through some of those possible factors you could think about when deciding.

What Is Your Passion?

You’ve decided you have a passion for nursing, which is a great start.

Let’s break that down.

Think about what that means to you.

It might not be as straight forward as it seems.

Of course, you might have already realised you would love to work with a particular group of people, or decided between adults and children.

But you might still like to think about whether you should consider specialising between people with learning disabilities, or mental health issues for example.

Maybe you really want to work with children, in hospital or the community.

You might have an interest in children who have mental health issues.

In this case, you might want to look at children’s nursing.

Or your interest in mental health might lead you to consider mental health nursing.

Alternatively, you might have experience working with children who have learning disabilities and know this is the avenue you would like to follow.

The same could be said when deciding which route to follow if your passion is working with adults.

As you can see this could get confusing!

If you are struggling to decide, it might clarify your thoughts to write down your ideas and reasons for going into nursing.

Think about who and what kinds of people you want to work with and support the most.

Then look at your reasons for this, and try to see which specialism most closely links to your reasons and passions.

If you have a clear, specific idea of where you would like to end up working, such as an epilepsy ward for children, try to find a job vacancy for that particular role.

Then have a look at the requirements.

Some jobs do ask for Registered Adult Nurse, or must be a Mental Health Nurse.

There is no guarantee this will be the same requirement when you finish your course, but it might give you more of an idea if you are heading in the right direction with your choices.

Your Dream As A Reality

The dream is to become a registered nurse, helping people live their lives in the best way possible.

But what is the reality of the role?

Although all nurses have skills, knowledge, and tasks in common, each specialism is slightly different day to day.

If you would like to work in a secure unit or the prison services, delivering person-centred care to some of the most vulnerable people, then you might enjoy mental health nursing.

A person can develop mental health issues for a wide range of issues, including major life events such as divorce, bereavement, alcohol or drug abuse, and other changes in personal circumstances.

Mental health nurses often meet people during this crisis point, working with them to problem-solve, referring to therapies if necessary.

They also work with people who have long-term mental health issues, and these people are likely not in crisis but appreciate tools to support them to adapt to every-day living as independently as possible.

You might enjoy this path if you like building up working relationships quickly, establishing trust with the person and their family.

This could be in a hospital or in-patient unit, or in the community.

Perhaps you would like to lead a team of support workers, engaging with service users and their families to give excellent care, focussing on social as well as medical aspects.

You might imagine yourself working in a residential or care home setting, in the community, or specialist respite services to name a few.

Learning disability nursing can involve assessing people to ensure they receive the right services, liaising with social workers, psychiatrists, and the wider team, as well as family members if appropriate.

You will learn about the law around mental capacity and how to best advocate for someone with learning disabilities.

Although people with learning disabilities can also be diagnosed with the same range of health issues as anyone else, there are some that are more prevalent in this population.

Consequently, learning disability nursing gives you the chance to specialise in, for example, autism, Down’s syndrome, or physical conditions including epilepsy, or diabetes.

This could be a consideration when choosing this path.

You might imagine yourself working in a hospital setting, on a ward, expanding your clinical skills to include further training on cannulation, taking bloods, setting up IV drips, and supporting people when they are very physically ill.

This is more typical of adult nursing, or children’s nursing if working with those under the age of 18.

In nurse training, adult and children nursing is split into two separate courses.

You might be able to ‘top-up’ your degree once qualified so you become dual qualified, however if this is your original aim you might be better looking for dual courses from the outset.

If you do not have a clear preference for working with adults or children, it might help to try and think of the environments you will be working in.

If you have experience working with children, in schools or play centres, that is a great start.

Remember children are not mini-adults – they have their own specific health needs, as well as their own way of communicating their needs.

Children, especially young children, may benefit from a nurse who can use a variety of different techniques to communicate, as well as being able to interpret body language to ascertain how the child is feeling.

A children’s nurse works with all children, from new-borns to adolescents.

As well as clinical duties, they also ensure a child is developing well and organise treatment plans and referrals to specialists if this is not the case.

Be prepared to work with children at all stages of development – this can include end of life care, which is not for everyone.

It can be distressing and emotional, but also hugely rewarding.

A children’s nurse can work in a variety of places, such as hospitals, the community, hospices, and travel companies.

Think About The Skills You Already Possess

A university course will help you develop the skills you need to be a nurse and deliver excellent care.

However, at the beginning, think about what skills you already possess.

A very valuable skill all nurses have is communication.

However, communicating with adults is different to talking to children, and different again for people with learning disabilities or those in a mental health crisis.

Could you explain complex medical issues using simpler sentences, pictures, or even sign language?

What about using technology.

Some people, especially those with learning or neurological disabilities, rely on assisted technology to communicate.

There are many different types, and if you are working with several people who have these you might find each person has their own computer aid.

You might be expected to acquire a basic understanding of each one, for example in case it breaks while the person is in your care.

Although this can of course be learnt, if you are someone who is terrified of technology then it might be something worth bearing in mind and researching a bit more.

When people talk about nursing skills, often empathy is mentioned.

This does not mean you can only work with people who have had the same experiences as you.

It is the ability to listen to others, and then understand what they were feeling and going through as if we were also experiencing it.

Empathy is essential for all strands of nursing, however it can be particularly useful for those whose experiences might be outside the norm.

This can include people with learning disabilities and the unique challenges they can face such as discrimination and accessing mainstream services, or people who have mental health issues and feelings of being misunderstood.

You might feel particular empathy with children and their families.

Think about who you most relate to, as on placements and after qualifying, working day to day with people will be your main focus.

Really empathising and acknowledging the people you support is a key skill, both for their continuing health and to build up positive working relationships.

If you feel the area you would like to work in is totally beyond your experiences, remember empathy is also validating the other person’s experiences and feelings, not saying you can understand everything they have gone through.

Most nursing skills and knowledge are needed in all specialities.

Make sure you research the different roles to make an informed choice.

Once qualified, there are often opportunities to gain clinical skills in all areas which might not immediately seem obvious to the job role.

For example, you might assume only adult nurses will learn about IVs and phlebotomy (taking bloods).

However, it is also the case that many nurses in mental health, learning disabilities, and working with children also train in these skills.

It can depend on the job you take once qualified, for example an essential skill for the people you will be supporting included in your induction training.

Alternatively, you might get the chance to gain extra training in a variety of clinical techniques in case you need them in the future.

For example, some NHS preceptorships include a broad range of clinical skills, which all newly qualified nurses employed by that Trust learn together, regardless of their current ward or workplace.

Consider Your Experience

All nursing courses require some experience before you are likely to be accepted.

You can gain experience in a variety of places, anywhere nurses work.

If you are unsure whether your experience is relevant, contact the admissions tutor for the course which you should be able to find on the university course’s website.

Maybe you do not have much experience in care or nursing related roles.

If you know you would like to be a nurse, but are truly struggling with what speciality you would like to qualify in, now is your chance to gain experience in a variety of areas and see what you think.

If you can afford it, you could offer to volunteer in an area of interest for a few hours a week, or even just a couple of days to get a feel for it.

Alternatively, you can sign up to an agency for care work.

This is a great way to work in a number of different places in a short space of time.

The NHS has NHS Professionals, which is their own internal version of agency work.

Have a look on the NHS website for more details if this is something you would like to apply for.

This work experience might surprise you, and you may end up loving an area of nursing you had not considered or did not think would appeal to you.

On the other hand, the realities of the job might persuade you that perhaps this is not an area you are so keen on after all.

A week or so of work experience could ultimately save you three years’ of studying an area of nursing you would not enjoy, so you will be free to choose another area instead.

You could ask your work experience to provide a reference, which will be a valuable addition to your university application.

It will also give you something to talk about and draw upon during a university course interview, and for your personal statement.

Making The Right Choice

There is a lot of overlap and similarities between the different types of nurses.

In the end, your course and route to qualifying will run a lot smoother if you are committed and doing something you really enjoy.

Your enthusiasm will be noticed and appreciated by the people you are supporting.

Hopefully this article has given you an insight into factors you could think about, taking into account you will be on placement with others who share your passion.

If you feel like you cannot get that excited about working on an adult ward, but would love working with children – well, you get the idea.

Once you have chosen which area you would like to study, make sure to convey all your experience and enthusiasm on application forms and course tutors.

Most of all, enjoy learning and developing your skills as you will be well on your way to becoming a qualified nurse!

Let me know in the comments your thoughts on choosing a nursing specialism and what I've said about above - let's chat there!

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